Smartphones used by nurses to meet data demands

A new study finds that more than two-thirds of nurses are using their personal smartphones for clinical communications. Yet 95% of nurses in the sample say hospital IT departments don't support that use for fear of security risks.

The report, "Healthcare without Bounds: Point of Care Computing for Nursing 2012," by Spyglass Consulting Group, points to the collision of healthcare information demands on nurses, and the limits of mobile and wirelesstechnology, at the point of care -- typically the patient's bedside. Nurses in the survey decry the lack of IT support; and IT staff are frustrated by the unsanctioned and often explicitly banned use of personal devices for clinical communications.

The report is based on in-depth phone interviews with 100 nurses in a variety of healthcare organizations in 33 states, focusing on the information requirements of nursing and the use of mobile and wireless technology to meet those requirements. About half of the respondents were registered nurses with a Bachelor of Science in nursing; nearly 40% were registered nurses with a Master's degree in nursing informatics.

The majority of nurses in the survey complain that hospital administrators are pressuring nurses to document care ever more thoroughly, to satisfy the growing number of government mandates, maximize reimbursements from third-party payers, and protect the hospital from lawsuits, according to Gregg Malkary, founder and managing director for Spyglass. The complete market study, "Healthcare without Bounds: Point of Care Computing for Nursing 2012," is available from Spyglass for $2,495.

The rising healthcare information demands are creating resentment. For example, a majority of nurses in the survey complained that they're being reduced to mere data collectors to satisfy "meaningful use" requirements, which are federal rules that healthcare providers must meet to qualify for federal incentive funding under the American Recovery and Reinvestment Act of 2009. Failure to do so can lead to big cuts in Medicare and Medicaid reimbursements, according to Malkary.

He found that a majority of nurses interviewed say the "meaningful use" requirements are almost entirely physician-centered, ignoring data needed by nurses. And they say they're becoming simply extensions of the IT group's own requirement to achieve compliance with meaningful use rules.

It's this information demand that drives 69% of nurses in the survey to rely on their personal smartphones at work. "These solutions fill in critical communications gaps BUT they are not sanctioned by hospital IT," notes the Spyglass report.

In fact, such use is actively banned in many cases. One IT systems analyst at an academic hospital told Malkary, "Nursing administration has mandated that personal communications by nurses during normal work hours is not acceptable. Nurses found to be using their personal devices during work hours will be disciplined."

The widespread use of personal smartphones is due partly to the fact they don't require extensive integration with IT infrastructures. Tablets are more likely to require "significant integration," according to the report.

At the same time, these nurses are deeply dissatisfied with current tablets, including Apple's iPad, which is spreading rapidly in the rest of the enterprise market. Asked if the Apple iPad was "ready to transform nursing care at the patient's bedside," nearly all of respondents -- 96% -- said "no." They gave the iPad good grades compared to traditional, Windows-based tablet PCs -- for being lighter, more intuitive, and having a longer battery life. Yet the Apple tablet, and its Android rivals, can't be properly cleaned and disinfected, lacks durability, and is weakened by the dearth of native clinical applications.

"Nurses interviewed believe that the Apple iPad would not be the ideal device for a bedside nurse because the bedside nurse has more extensive documentation requirements that require a fullsize screen, keyboard and mouse," according to the report.

Malkary goes so far as to say that nurses have "rejected" tablets for nursing workflows.

One in 4 of the survey respondents reported being dissatisfied with the quality and reliability of their facility's wireless LAN.

Security concerns by hospital administrators and IT groups are well-founded. Mobile devices can be lost or stolen, employees are often resistant to the use of strong password protection and data encryption, and can download personal apps that may be either insecure or designed as malware.

Among the Spyglass recommendations:

much more proactive and vigorous efforts by IT to identify hospital workers' requirements for mobile technology

define enforceable policies and procedures for personal devices on the hospital network

expand help desk resources with skilled personnel dedicated to mobile technology support